Evidence map›Paper›PMID 41380056›Full record

ArticleThe western journal of emergency medicine2025

Limiting Albuterol Use by EMS at the Start of the COVID-19 Pandemic: A Retrospective Analysis of Rapid Deimplementation.

Renoj Varughese, Susan J Burnett, Hilary Kirk, Ian Wallis, Nan Nan, Chang-Xing Ma, David Hostler, Brian M Clemency

Abstract read
In one paragraph

Article in The western journal of emergency medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

What it found

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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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3 · Its place in the literature

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4 · The record

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5 · Who and what money

Authors and funding

8 authors.

Renoj VarugheseUniversity of Buffalo, The State University of New York, Jacobs School of Medicine and Biomedical Sciences, Department of Emergency Medicine, Buffalo, New York.
Susan J BurnettUniversity of Buffalo, The State University of New York, Jacobs School of Medicine and Biomedical Sciences, Department of Emergency Medicine, Buffalo, New York.
Hilary KirkUniversity of Buffalo, The State University of New York, Jacobs School of Medicine and Biomedical Sciences, Department of Emergency Medicine, Buffalo, New York.
Ian WallisUniversity of Buffalo, The State University of New York, Jacobs School of Medicine and Biomedical Sciences, Department of Emergency Medicine, Buffalo, New York.
Nan NanUniversity of Buffalo, The State University of New York, School of Public Health and Health and Health Professions, Department of Biostatistics, Buffalo, New York.
Chang-Xing MaUniversity of Buffalo, The State University of New York, School of Public Health and Health and Health Professions, Department of Biostatistics, Buffalo, New York.
David HostlerUniversity of Buffalo, The State University of New York, Jacobs School of Medicine and Biomedical Sciences, Department of Emergency Medicine, Buffalo, New York.
Brian M ClemencyUniversity of Buffalo, The State University of New York, Jacobs School of Medicine and Biomedical Sciences, Department of Emergency Medicine, Buffalo, New York.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionDeimplementation is the process through which an existing practice, procedure, or protocol is discontinued. Past deimplementation efforts in emergency medical services (EMS), such as reduction of liberal oxygen administration, backboard use, and lights and sirens responses, have been slow in rates of change and had varying levels of adoption. Our objective in this study was to analyze the deimplementation of albuterol administration in the beginning of the 2019 novel coronavirus (COVID-19) pandemic for the adoption of deimplementation guidelines, rate of change, and factors leading to this change in EMS practice.

methodsUsing the 2020 National Emergency Medical Services Information System (NEMSIS) dataset, we analyzed the change in EMS calls with albuterol administration following the US Centers for Disease Control and Prevention (CDC) advisory recommending limiting aerosol-generating procedures in response to the COVID-19 pandemic.

resultsThe 2020 NEMSIS dataset included 43,488,767 total records, and 449,290 (1.0%) records included at least one albuterol administration. Calls with albuterol administration dropped 61.7% in a near-linear fashion in the six weeks following the publication of the CDC's guidance (from March 8-April 18, 10,426 absolute reduction; from 16,891 to 6,465, in average calls per week with albuterol administration). In the period before the guidance, there were on average 16,891 calls with albuterol administration of 640,597 (2.6%) calls per week. In the period after the guidance, there were, on average, 6,465 calls with albuterol administration of 601,943 (1.1%) calls per week. Therefore, while total EMS calls declined by 6% during the transition period, the proportion of albuterol calls within this decline went down by 1.5% (2.6% to 1.1%), reflecting rapid deimplementation.

conclusionDeimplementation of albuterol administration in the beginning of the COVID-19 pandemic was significant in its rate and success in adherence to guidelines when compared to other changes in EMS policies, procedures, and protocols. A better understanding of deimplementation can guide future EMS efforts to phase out ineffective practices while minimizing disruption to care.

Indexed as

AlbuterolBronchodilator AgentsCOVID-19Emergency Medical ServicesGuideline AdherenceHumansPractice Guidelines as TopicRetrospective StudiesSARS-CoV-2United StatesAlbuterolBronchodilator Agents

Identifiers

PMID41380056
PMCPMC12698141

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.